Alcohol Treatment Centre, Lausanne University Hospital CHUV, Lausanne, Switzerland.
Department of Psychiatry and Human Behavior, University of Mississipi Medical Center, Jackson, MS, USA.
J Affect Disord. 2018 May;232:243-251. doi: 10.1016/j.jad.2018.02.028. Epub 2018 Feb 17.
Research has identified several correlates of suicidal behaviors including depressive symptoms, alcohol use and coping drinking motives. However, their associations and their role as possible causal mechanisms in the prediction of suicide attempt are not well understood. This study examined, both cross-sectionally and longitudinally, the potential pathways from alcohol use, drinking coping motives, and depression to suicide attempts.
Participants (N = 4617) were young Swiss men (mean age = 19.95) participating in the Cohort Study on Substance Use Risk Factors. Measures of depressive symptoms, alcohol use (total drinks per week, heavy episode drinking) and coping drinking motives were used from the baseline and/or 15-month follow-up assessments to predict follow-up suicide attempt.
Main findings showed indirect associations through depressive symptoms, such that coping drinking motives were positively associated with depressive symptoms, which were in turn positively related to suicide attempts over time (for total drinks per week models, cross-sectional model: B = 0.130, SE = 0.035, 95% CI = 0.072, 0.207; longitudinal model: B = 0.039, SE = 0.013, 95% CI = 0.019, 0.069). Alcohol use was not significantly related to suicide attempt.
Main limitation includes a low prevalence rate for suicide attempt potentially reducing power effects in the analyses and our focus on distal-yet not proximal, role of alcohol use on suicide attempt.
Findings of this study suggest that young men with depressive symptoms and/or those who use alcohol to cope with negative affect may benefit from programs targeting suicidal behaviors.
研究已经确定了一些与自杀行为相关的因素,包括抑郁症状、饮酒和应对性饮酒动机。然而,它们之间的关联以及它们作为自杀企图预测的可能因果机制的作用尚未得到很好的理解。本研究分别在横断面和纵向研究了饮酒、应对性饮酒动机和抑郁与自杀企图之间的潜在途径。
参与者(N=4617)为参加物质使用风险因素队列研究的年轻瑞士男性(平均年龄=19.95 岁)。使用基线和/或 15 个月随访评估中的抑郁症状、饮酒(每周总饮酒量、重度饮酒事件)和应对性饮酒动机来预测随访期间的自杀企图。
主要发现显示了通过抑郁症状的间接关联,即应对性饮酒动机与抑郁症状呈正相关,而抑郁症状又与随时间推移发生的自杀企图呈正相关(对于每周总饮酒量模型,横断面模型:B=0.130,SE=0.035,95%CI=0.072,0.207;纵向模型:B=0.039,SE=0.013,95%CI=0.019,0.069)。饮酒与自杀企图无显著相关性。
主要局限性包括自杀企图的低发生率可能会降低分析中的效力,以及我们关注的是酒精使用对自杀企图的远端而非近端作用。
本研究结果表明,有抑郁症状和/或使用酒精应对负面情绪的年轻男性可能受益于针对自杀行为的项目。